Provider Demographics
NPI:1316330525
Name:CHEN, SHARA MAE SISON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHARA MAE
Middle Name:SISON
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4208 EVERGREEN LN STE 213
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3254
Mailing Address - Country:US
Mailing Address - Phone:703-642-7522
Mailing Address - Fax:703-642-7565
Practice Address - Street 1:4208 EVERGREEN LN STE 213
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3254
Practice Address - Country:US
Practice Address - Phone:703-642-7522
Practice Address - Fax:703-642-7565
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA52331363A00000X
VA0110006465363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant